Contract Pharmacy Details

ASPCARES
FQHCLA378A SOUTH CNTRL HOU COMM

Covered Entity Details

Entity Name

SOUTH CNTRL HOU COMM

Subdivision Name

Martin Luther King Site

Type

Health Center Program Look-Alike

340B ID

FQHCLA378A

Entity Address

8610 Martin Luther King Jr. Blvd
Houston, TX 77033

Grant Number

LALCS32107

Participating Start Date

10/30/2018

Last Recertification Date

1/29/2019

Entity Termination Date

4/1/2020

Pharmacy Details

Pharmacy Name

ASPCARES

Pharmacy Address

3009 FANNIN ST
HOUSTON, TX 77004-2805

Pharmacy Comments

Contract Details

Approval Date

1/11/2019

Contract Begin Date

4/1/2019

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2020
Covered Entity Terminated

Contacts

Covered Entity Signing Official

La Toya Darden, CEO
(713) 734-0199 Ext: 1072

Contract Pharmacy Representative

ASP Cares
Syed Amir Saeed, CEO
(586) 764-3302

Signed By Date

1/11/2019